Editorial: How to cut Medicare costs

Tuesday

Mar 27, 2012 at 12:01 AMMar 27, 2012 at 7:12 PM

The Supreme Court this week will consider the constitutionality of the individual mandate. But another part of the federal health reform law is the focus of intense opposition from Republicans and the health care industry: The Independent Payment Advisory Board.

The Supreme Court this week will consider the constitutionality of the individual mandate. But another part of the federal health reform law is the focus of intense opposition from Republicans and the health care industry: The Independent Payment Advisory Board.

This issue is part of a larger set of GOP contradictions on Medicare. Conservatives are always inveighing against government spending. Washington needs to cut the spending, especially on Medicare, which is the fastest-growing part of the federal budget. The way to restrain the growth in health care costs is to empower knowledgeable consumers and use the power of the market to drive down health costs.

Fine, but why did Republicans base their 2010 campaign on complaints that the Affordable Care Act called for reducing projected increases in Medicare spending by $500 billion over 10 years? If government should cut spending, why are they against cutting spending?

Now the opposition is determined to stop the IPAB, the panel, established to make decisions on what treatments and procedures Medicare should and shouldn’t pay for.

We understand why the medical and pharmaceutical industries would be against this. Medicare is a vast pot of money, and no business big enough to hire a lobbyist wants his product or service cut out of the action — especially by an independent board of experts impervious to political pressure.

The popular assumption that education consumers can control health care costs doesn’t, for the most part, hold up in the real world. Consumers don’t have the expertise or the objectivity required to second-guess their physicians.

But the IPAB is an expert, dispassionate board, one capable of examining the relevant research and determining if the new treatment, which may cost many times as much as the old treatment, is really more effective. If it is, the panel will give it the green light; if it isn’t, the panel would determine that the taxpayers shouldn’t have to pay for it.

Conservatives should embrace the IPAB. If you really believe informed consumers can help restrain health costs, what’s not to like? Medicare is the largest health care consumer. The IPAB is prepared and empowered to make decisions about which treatments are worth it for the patient and the taxpayer. How can you be in favor of informed consumers, and in favor of reducing government spending, and still insist that the government keep spending on treatments that don’t work?

Yet it’s the Republicans, following Sarah Palin’s lead, who dubbed IPAB the “death panel,” and Republicans who hope to repeal it along with the rest of the Affordable Care Act. Rep. Paul Ryan’s GOP budget would change Medicare to a voucher system — he prefers the term “premium support” — which would cap the government’s contribution to Medicare recipients’ medical bills, while taking away the tool Medicare could use to restrain health cost inflation. What’s conservative about that?

MetroWest Daily News

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